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Rationale and evidence on the use of tocilizumab in COVID-19: a systematic review

2020; Elsevier BV; Volume: 27; Issue: 1 Linguagem: Inglês

10.1016/j.pulmoe.2020.07.003

2531-0437

Andrea Cortegiani, Mariachiara Ippolito, Massimiliano Greco, V. Granone, Alessandro Protti, Cesare Gregoretti, Antonino Giarratano, Sharon Einav, Maurizio Cecconi,

COVID-19 Impact on Reproduction

Tocilizumab is an IL-6 receptor-blocking agent proposed for the treatment of severe COVID-19. The aim of this systematic review was to describe the rationale for the use of tocilizumab for the treatment of COVID-19 and to summarize the available evidence regarding its efficacy and safety. MEDLINE, PubMed, EMBASE, pre-print repositories (bioRxiv and medRxiv) and two trial Registries were searched for studies on the use of tocilizumab in COVID-19 or SARS-CoV-2 infection, viral pneumonia, and/or sepsis until 20th June 2020. We identified 3 indirect pre-clinical studies and 28 clinical studies including 5776 patients with COVID-19 (13 with a comparison group, 15 single-arm). To date, no randomized trials have been published. We retrieved no studies at low risk of bias. Forty-five ongoing studies were retrieved from trial registries. There is insufficient evidence regarding the clinical efficacy and safety of tocilizumab in patients with COVID-19. Its use should be considered experimental, requiring ethical approval and clinical trial oversight.